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Survival guide group4e
Survival guide group4e
Survival guide group4e
Survival guide group4e
Survival guide group4e
Survival guide group4e
Survival guide group4e
Survival guide group4e
Survival guide group4e
Survival guide group4e
Survival guide group4e
Survival guide group4e
Survival guide group4e
Survival guide group4e
Survival guide group4e
Survival guide group4e
Survival guide group4e
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Survival guide group4e

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Group4E

Group4E

Published in: Health & Medicine
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  • Transcript

    • 1. Newly
Qualified
Nurses
 Survival
Guide Group
4E
    • 2. Content PageTitle SlideTips for newly qualified nurse............3List of Abbreviations.........................4-5Normal ranges......................................6Analgesic Pain scale.............................7Emergency Protocols.............................9Drug Calculations................................10Waterlow guidelines.........................11-15ECG leads Placement .........................16
    • 3. Tips
For
Newly
Qualified
NursesIt is advisable to have fob watch (not on your wrist!) with a secondhand for three main reasons:Telling the timePunctualityAnd taken patients pulseNeed to make sure you have a pen (preferably black). NMC guidelinesfor records and record keeping” (2004) only recommends that notescan be “readable on any photocopies”.Its a good idea to purchase your own stethoscope.Get a drug book e.g. a BNF to get use to the main drugs used on the
    • 4. List of abbreviationsABG – arterial blood gas CRP- Cardiopulmonary resuscitationAC- before food Cr- creatinineADH- antidiuretic hormone CSF- cerebrospinal fluidAIDS- acquired immune deficiency CVC- central venous catheterSyndrome CVP- central venous pressureARDS- acute respiratory distress DNAR- do not attempt resuscitationsyndrome DVT- deep vein thrombosisARF- acute renal failure ECG- electrocardiogramAV- atrioventricular FWB- full weight bearingBD- twice daily  GCS- Glasgow coma scaleBMI- body mass index GFR- glomerular filtration rateBP- blood pressure GI- gastrointestinal  BUN- blood urea nitrogen GUTT- eye dropsCDs- controlled drugsCNS- central HNIg- Human normal immunoglobulinnervous system HLV- human lymphoma virusCO- Cardiac output or Carbon monoxide IC- inspiratory capacity CO2- carbon dioxide IDDM- insulin-dependentCOPD- chronic obstructive pulmonarydisease
    • 5. IM- intramusclar PO- by mouthIV- intravenous POM- prescribed only medicationMAP- mean arterial pressure PR- per rectumMI- myocardial infarction  PRN- as requiredMRSA- methicillin resistant PV- per vaginastaphylococcus aureus QDS- four times dailyNG- nasogastric  QQH- every four hoursNSAID- non- steroidal anti RV- residual volumeinflammatory drug SCC- spinal cord compressionNWB- non weight bearing SI- sublingualOCC- eye cream STAT- immediatelyOM- every morning SUB CUT- subcutaneousON- every night TB- tuberculosis P- Pharmacy medicines TEDS- thromboembolic deterrentPaCO2- partial pressure of carbon dioxide stockingPC- after food TDS/ TLD- three times dailyPCA- patient controlled analgesic TLC- total lung capacityPEG- percutaneous endoscopically placed VF- ventricular fibrillation gastrostomy
    • 6. Normal RangesNormal Pulse Rates TemperatureNew born 120 – 160 Armpit: 34.7oC to 37.3oC1 – 2 months 80 – 140 Mouth: 35.5oC to 37.5oC1 – 2 years 80-130 Ear: 35.8oC to 38oC2 – 6 years 75 – 1206 – 12 years 75- 11012 – adult 60 – 100 Normal Bloods Values Biochemistry Abumin 35 – 50 g/lAverage Blood Pressure Amylase 25 – 125 u/l1 year 95/65 Bicarbonate 22 – 30 mmol/l6 – 9 years 100/65 Bilirubin 3 – 17 mmol/lAdult 110/65 – 140/90 Calcuim 2.12 – 2.67 mmol/lAverage Respiratory Rate Cholesterol 3.5 – 6.5 mmol/lNewborn 30 – 80/min Creatinine 70 – 150 mmol/lEarly childhood 20 – 40/min Glucose 3.6 – 5.5 mmol/lLate childhood 15 – 18/min Potassium 3.5 – 5.0 mmol/lAdulthood 16 – 20/min Sodium 136 – 138 mmol/l" Urea 2.5 – 6.7"Normal Adult Urine ValuesOutput/24 hours 1000 – 15000 mls HaematologyPH 6 Haemoglobin (Hb)Specific Gravity 1.001 – 1.035 Male 13.5 – 17.7 g/dl Female 11.5 – 16.5 g/dl White Blood Count (WBC) 4 – 11 x 109/L Platelet count 150- 400 x10g/lOxygen Saturation level above 95% " " " " " " " " " " " "
    • 7. Analgesic Pain Scale
    • 8. Guidelines for Analgesic Pain Scale Mild pain:                   Step 1: Simple analgesics (non-opioid) Initiate topical and/or simple oral non-opioid analgesics (e.g. paracetamol, NSAIDs)+ adjuvant e.g. tricyclic antidepressants, anticonvulsants (pregabalin or gabapentin) for neuropathic pain. Moderate pain:           Step 2: Weak opioid Weak opioid (e.g. tramadol, codeine phosphate or dextropropoxyphene) + adjuvant e.g. tricyclic antidepressants, anticonvulsants Severe pain:                Step 3: Strong opioid Opioids (e.g. morphine, oxycodone) + adjuvant e.g. tricyclics, anticonvulsants
    • 9. Emergency Protocols
    • 10. Emergency ProtocolsFirst Response of finding • Start chest compressions if nopatient. sign of response.• A=Airway • Have crash trolley in position withChecking patient airway is defibrillator charged. free from obstruction. • D=Disability• B=Breathing Observe patients motor response andPatient breathing by use Glasgow Coma Scale.observing chest movement and • E=Environmentadminister oxygen. Observe what is surrounding patient• C=Circulation ensure further harm cannot become ofObserving patients pallor and the patient.checking for pulse.• Call for help.• Ensure crash team notifiedby ringing 2222 emergencynumber.
    • 11. Drug
Calcula<ons
    • 12. Drug
Calcula<onsTablet formula: dose prescribed/Dose per tabletIV formula: amount required x drops Per hour min5 R’s are vital to check before administration of any drugs.Right PatientRight Route Right DoseRight TimeRight DrugAlways check notes for allergies and double check with the patient
    • 13. Guidelines for completing the Waterlow Pressure Ulcer Risk Assessment
    • 14. Guidelines for completing the Waterlow Pressure Ulcer Risk AssessmentPlease note that this is intended to act as a guide only, and should be used in conduction and to support clinical judgmentSex Examples scoreMale Self explanatory 1
    • 15. Guidelines for completing the Waterlow Pressure Ulcer Risk AssessmentPlease note that this is intended to act as a guide only, and should be used in conduction and to support clinical judgmentSex Examples scoreMale Self explanatory 1Female Self explanatory 2
    • 16. Guidelines for completing the Waterlow Pressure Ulcer Risk AssessmentPlease note that this is intended to act as a guide only, and should be used in conduction and to support clinical judgmentSex Examples scoreMale Self explanatory 1Female Self explanatory 2Age Examples Score
    • 17. Guidelines for completing the Waterlow Pressure Ulcer Risk AssessmentPlease note that this is intended to act as a guide only, and should be used in conduction and to support clinical judgmentSex Examples scoreMale Self explanatory 1Female Self explanatory 2Age Examples ScoreAge Please determine 1-5
    • 18. Guidelines for completing the Waterlow Pressure Ulcer Risk AssessmentPlease note that this is intended to act as a guide only, and should be used in conduction and to support clinical judgmentSex Examples scoreMale Self explanatory 1Female Self explanatory 2Age Examples ScoreAge Please determine 1-5 
    • 19. Guidelines for completing the Waterlow Pressure Ulcer Risk AssessmentPlease note that this is intended to act as a guide only, and should be used in conduction and to support clinical judgmentSex Examples scoreMale Self explanatory 1Female Self explanatory 2Age Examples ScoreAge Please determine 1-5  Appetite
    • 20. Guidelines for completing the Waterlow Pressure Ulcer Risk AssessmentPlease note that this is intended to act as a guide only, and should be used in conduction and to support clinical judgmentSex Examples scoreMale Self explanatory 1Female Self explanatory 2Age Examples ScoreAge Please determine 1-5  Appetite Examples Score
    • 21. Guidelines for completing the Waterlow Pressure Ulcer Risk AssessmentPlease note that this is intended to act as a guide only, and should be used in conduction and to support clinical judgmentSex Examples scoreMale Self explanatory 1Female Self explanatory 2Age Examples ScoreAge Please determine 1-5  Appetite Examples ScoreAverage Eats enough to maintain weight 0
    • 22. Guidelines for completing the Waterlow Pressure Ulcer Risk AssessmentPlease note that this is intended to act as a guide only, and should be used in conduction and to support clinical judgmentSex Examples scoreMale Self explanatory 1Female Self explanatory 2Age Examples ScoreAge Please determine 1-5  Appetite Examples ScoreAverage Eats enough to maintain weight 0Poor/lack of appetite Eats no more than ½ of each meal/ needs supplements 1
    • 23. Guidelines for completing the Waterlow Pressure Ulcer Risk AssessmentPlease note that this is intended to act as a guide only, and should be used in conduction and to support clinical judgmentSex Examples scoreMale Self explanatory 1Female Self explanatory 2Age Examples ScoreAge Please determine 1-5  Appetite Examples ScoreAverage Eats enough to maintain weight 0Poor/lack of appetite Eats no more than ½ of each meal/ needs supplements 1
    • 24. Build/ Weight for Height Examples ScoreAverage Weigh patient and calculate BMI 0Above Average Weigh patient and calculate BMI 1Obese Weigh patient and calculate BMI 2Below Average Weigh patient and calculate BMI 3 Continence Examples Score 
    • 25. Build/ Weight for Height Examples ScoreAverage Weigh patient and calculate BMI 0Above Average Weigh patient and calculate BMI 1Obese Weigh patient and calculate BMI 2Below Average Weigh patient and calculate BMI 3 Continence Examples Score Complete/catheter fully continent and non-leaking catheter 0
    • 26. Build/ Weight for Height Examples ScoreAverage Weigh patient and calculate BMI 0Above Average Weigh patient and calculate BMI 1Obese Weigh patient and calculate BMI 2Below Average Weigh patient and calculate BMI 3 Continence Examples Score Complete/catheter fully continent and non-leaking catheter 0Urinary incontinent incontinent of urine> 1in 12 hours 1
    • 27. Build/ Weight for Height Examples ScoreAverage Weigh patient and calculate BMI 0Above Average Weigh patient and calculate BMI 1Obese Weigh patient and calculate BMI 2Below Average Weigh patient and calculate BMI 3 Continence Examples Score Complete/catheter fully continent and non-leaking catheter 0Urinary incontinent incontinent of urine> 1in 12 hours 1 (inc. On newly prescribed diuretics, or UTI)
    • 28. Build/ Weight for Height Examples ScoreAverage Weigh patient and calculate BMI 0Above Average Weigh patient and calculate BMI 1Obese Weigh patient and calculate BMI 2Below Average Weigh patient and calculate BMI 3 Continence Examples Score Complete/catheter fully continent and non-leaking catheter 0Urinary incontinent incontinent of urine> 1in 12 hours 1 (inc. On newly prescribed diuretics, or UTI)Faecally incontinent Incontinent of faeces at least once per day 2
    • 29. Build/ Weight for Height Examples ScoreAverage Weigh patient and calculate BMI 0Above Average Weigh patient and calculate BMI 1Obese Weigh patient and calculate BMI 2Below Average Weigh patient and calculate BMI 3 Continence Examples Score Complete/catheter fully continent and non-leaking catheter 0Urinary incontinent incontinent of urine> 1in 12 hours 1 (inc. On newly prescribed diuretics, or UTI)Faecally incontinent Incontinent of faeces at least once per day 2Doubly incontinent Incontinent of urine and faeces with no control or awareness 3
    • 30. Mobility Examples Score
    • 31. Mobility Examples ScoreFully Walk any distance unaided by staff, able to reposition self independently 0
    • 32. Mobility Examples ScoreFully Walk any distance unaided by staff, able to reposition self independently 0Restless/fidgety Restless 1
    • 33. Mobility Examples ScoreFully Walk any distance unaided by staff, able to reposition self independently 0Restless/fidgety Restless 1Apathetic Walks or repositions self but needs encouragement 2
    • 34. Mobility Examples ScoreFully Walk any distance unaided by staff, able to reposition self independently 0Restless/fidgety Restless 1Apathetic Walks or repositions self but needs encouragement 2Restricted nursed in bed or chair buts needs some assistance from staff to reposition 3
    • 35. Mobility Examples ScoreFully Walk any distance unaided by staff, able to reposition self independently 0Restless/fidgety Restless 1Apathetic Walks or repositions self but needs encouragement 2Restricted nursed in bed or chair buts needs some assistance from staff to reposition 3Bed Bound nursed in bed, only able to make slight changes to reposition 4
    • 36. Mobility Examples ScoreFully Walk any distance unaided by staff, able to reposition self independently 0Restless/fidgety Restless 1Apathetic Walks or repositions self but needs encouragement 2Restricted nursed in bed or chair buts needs some assistance from staff to reposition 3Bed Bound nursed in bed, only able to make slight changes to reposition 4(eg traction)
    • 37. Mobility Examples ScoreFully Walk any distance unaided by staff, able to reposition self independently 0Restless/fidgety Restless 1Apathetic Walks or repositions self but needs encouragement 2Restricted nursed in bed or chair buts needs some assistance from staff to reposition 3Bed Bound nursed in bed, only able to make slight changes to reposition 4(eg traction)Chair bound nursed in a chair, only able to make slight changes to reposition 5
    • 38. Mobility Examples ScoreFully Walk any distance unaided by staff, able to reposition self independently 0Restless/fidgety Restless 1Apathetic Walks or repositions self but needs encouragement 2Restricted nursed in bed or chair buts needs some assistance from staff to reposition 3Bed Bound nursed in bed, only able to make slight changes to reposition 4(eg traction)Chair bound nursed in a chair, only able to make slight changes to reposition 5(eg wheelchair)
    • 39. Mobility Examples ScoreFully Walk any distance unaided by staff, able to reposition self independently 0Restless/fidgety Restless 1Apathetic Walks or repositions self but needs encouragement 2Restricted nursed in bed or chair buts needs some assistance from staff to reposition 3Bed Bound nursed in bed, only able to make slight changes to reposition 4(eg traction)Chair bound nursed in a chair, only able to make slight changes to reposition 5(eg wheelchair)(Grade 1)
    • 40. Mobility Examples ScoreFully Walk any distance unaided by staff, able to reposition self independently 0Restless/fidgety Restless 1Apathetic Walks or repositions self but needs encouragement 2Restricted nursed in bed or chair buts needs some assistance from staff to reposition 3Bed Bound nursed in bed, only able to make slight changes to reposition 4(eg traction)Chair bound nursed in a chair, only able to make slight changes to reposition 5(eg wheelchair)(Grade 1)Special RisksExamples Score
    • 41. Mobility Examples ScoreFully Walk any distance unaided by staff, able to reposition self independently 0Restless/fidgety Restless 1Apathetic Walks or repositions self but needs encouragement 2Restricted nursed in bed or chair buts needs some assistance from staff to reposition 3Bed Bound nursed in bed, only able to make slight changes to reposition 4(eg traction)Chair bound nursed in a chair, only able to make slight changes to reposition 5(eg wheelchair)(Grade 1)Special RisksExamples ScoreTerminal Wasting & emaciation caused by severe or chronic disease, failure 8
    • 42. Mobility Examples ScoreFully Walk any distance unaided by staff, able to reposition self independently 0Restless/fidgety Restless 1Apathetic Walks or repositions self but needs encouragement 2Restricted nursed in bed or chair buts needs some assistance from staff to reposition 3Bed Bound nursed in bed, only able to make slight changes to reposition 4(eg traction)Chair bound nursed in a chair, only able to make slight changes to reposition 5(eg wheelchair)(Grade 1)Special RisksExamples ScoreTerminal Wasting & emaciation caused by severe or chronic disease, failure 8Cachexia/Multiple of > 1 vital organ
    • 43. Mobility Examples ScoreFully Walk any distance unaided by staff, able to reposition self independently 0Restless/fidgety Restless 1Apathetic Walks or repositions self but needs encouragement 2Restricted nursed in bed or chair buts needs some assistance from staff to reposition 3Bed Bound nursed in bed, only able to make slight changes to reposition 4(eg traction)Chair bound nursed in a chair, only able to make slight changes to reposition 5(eg wheelchair)(Grade 1)Special RisksExamples ScoreTerminal Wasting & emaciation caused by severe or chronic disease, failure 8Cachexia/Multiple of > 1 vital organOrgan failure
    • 44. Mobility Examples ScoreFully Walk any distance unaided by staff, able to reposition self independently 0Restless/fidgety Restless 1Apathetic Walks or repositions self but needs encouragement 2Restricted nursed in bed or chair buts needs some assistance from staff to reposition 3Bed Bound nursed in bed, only able to make slight changes to reposition 4(eg traction)Chair bound nursed in a chair, only able to make slight changes to reposition 5(eg wheelchair)(Grade 1)Special RisksExamples ScoreTerminal Wasting & emaciation caused by severe or chronic disease, failure 8Cachexia/Multiple of > 1 vital organOrgan failure Single organ failure Failure of 1 vital organ (inc. CCF) 5
    • 45. Mobility Examples ScoreFully Walk any distance unaided by staff, able to reposition self independently 0Restless/fidgety Restless 1Apathetic Walks or repositions self but needs encouragement 2Restricted nursed in bed or chair buts needs some assistance from staff to reposition 3Bed Bound nursed in bed, only able to make slight changes to reposition 4(eg traction)Chair bound nursed in a chair, only able to make slight changes to reposition 5(eg wheelchair)(Grade 1)Special RisksExamples ScoreTerminal Wasting & emaciation caused by severe or chronic disease, failure 8Cachexia/Multiple of > 1 vital organOrgan failure Single organ failure Failure of 1 vital organ (inc. CCF) 5Peripheral vascular disease Diagnosed vascular, ischemic disease of the lower limbs/extremities 5
    • 46. Mobility Examples ScoreFully Walk any distance unaided by staff, able to reposition self independently 0Restless/fidgety Restless 1Apathetic Walks or repositions self but needs encouragement 2Restricted nursed in bed or chair buts needs some assistance from staff to reposition 3Bed Bound nursed in bed, only able to make slight changes to reposition 4(eg traction)Chair bound nursed in a chair, only able to make slight changes to reposition 5(eg wheelchair)(Grade 1)Special RisksExamples ScoreTerminal Wasting & emaciation caused by severe or chronic disease, failure 8Cachexia/Multiple of > 1 vital organOrgan failure Single organ failure Failure of 1 vital organ (inc. CCF) 5Peripheral vascular disease Diagnosed vascular, ischemic disease of the lower limbs/extremities 5Anaemia (Hb<8) Haemoglobin <8 2
    • 47. Mobility Examples ScoreFully Walk any distance unaided by staff, able to reposition self independently 0Restless/fidgety Restless 1Apathetic Walks or repositions self but needs encouragement 2Restricted nursed in bed or chair buts needs some assistance from staff to reposition 3Bed Bound nursed in bed, only able to make slight changes to reposition 4(eg traction)Chair bound nursed in a chair, only able to make slight changes to reposition 5(eg wheelchair)(Grade 1)Special RisksExamples ScoreTerminal Wasting & emaciation caused by severe or chronic disease, failure 8Cachexia/Multiple of > 1 vital organOrgan failure Single organ failure Failure of 1 vital organ (inc. CCF) 5Peripheral vascular disease Diagnosed vascular, ischemic disease of the lower limbs/extremities 5Anaemia (Hb<8) Haemoglobin <8 2Smoking Any cigarette/tobacco 1
    • 48. Skin TypeExamples Score
    • 49. Skin TypeExamples ScoreHealthy No obvious Problem 0Tissue Paper Thin, fragile skin, reduced elasticity 1Dry Brittle, flaking, scales 1Oedematous Any oedema 1Clammy Sweating, pyrexia 1Discoloured (Grade1) Red, non-blanching, dusky 2Broken spot (Grade 2-4) Blister, skin break or black area on any pressure point 3
    • 50. Skin TypeExamples ScoreHealthy No obvious Problem 0Tissue Paper Thin, fragile skin, reduced elasticity 1Dry Brittle, flaking, scales 1Oedematous Any oedema 1Clammy Sweating, pyrexia 1Discoloured (Grade1) Red, non-blanching, dusky 2Broken spot (Grade 2-4) Blister, skin break or black area on any pressure point 3 Neurological deficitExamples Score
    • 51. Major Surgery /TraumaExamples ScoreOrthopaedic /spinal 5On table >2 hours Not counted after 48 hours if patient is recovering normally 5On table >6 hours Not counted after 48 hours if patient is recovering normally 8
    • 52. Major Surgery /TraumaExamples ScoreOrthopaedic /spinal 5On table >2 hours Not counted after 48 hours if patient is recovering normally 5On table >6 hours Not counted after 48 hours if patient is recovering normally 8 MedicationExamples Score
    • 53. ECG leads Placement
    • 54. GroupMembers Emily Asamoah   Deirdre Roche Maeve O-carrollRommel Retuerma Roxanne Burton Okako Rumanga Wayne Haswell

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